The nurse is educating a client about an inhaled corticosteroid. What statement will the nurse include?

Take this medication before bedtime to minimize side effects.

Rinse your mouth after each use.

Stop taking the medication if you gain 5 or more pounds in 1 week.

Use this medication on an empty stomach to improve its effectiveness.

Answer and Explanation

The Correct Answer is B

Choice A reason: Inhaled corticosteroids, such as fluticasone, are not specifically timed for bedtime to minimize side effects. Their primary effect is local anti-inflammatory action in the airways, with minimal systemic absorption. Timing does not significantly reduce side effects like oral thrush, which is managed by rinsing the mouth. Administration is typically twice daily for consistent asthma control, independent of bedtime.

Choice B reason: Rinsing the mouth after using inhaled corticosteroids is essential to prevent oral candidiasis (thrush). Residual corticosteroid in the oral cavity can disrupt the local microbial balance, promoting fungal overgrowth. Rinsing removes excess drug, reducing infection risk while maintaining the drug’s anti-inflammatory effect in the airways, ensuring safe and effective therapy.

Choice C reason: Weight gain of 5 pounds in a week is not a typical side effect of inhaled corticosteroids due to their minimal systemic absorption. Stopping the medication abruptly could exacerbate asthma symptoms. Significant weight gain is more associated with systemic corticosteroids, which affect metabolism and fluid retention, unlike inhaled formulations.

Choice D reason: Inhaled corticosteroids do not require an empty stomach for effectiveness, as they are delivered directly to the lungs via inhalation. Their local action on airway inflammation is independent of gastrointestinal absorption. Food intake does not influence their pharmacokinetics or therapeutic efficacy, making this instruction irrelevant for inhaled corticosteroid use.

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Correct Answer is B

Explanation

Choice A reason: Montelukast is not tapered or discontinued when symptoms improve, as it is a maintenance therapy for asthma. Stopping it may lead to recurrence of inflammation, as it blocks leukotriene receptors, preventing bronchoconstriction and inflammation, requiring consistent use for sustained control.

Choice B reason: Montelukast, a leukotriene receptor antagonist, requires daily oral administration to maintain its anti-inflammatory effects by blocking leukotriene D4 receptors. Continuous use prevents asthma exacerbations, even during symptom-free periods, ensuring long-term airway stability and reducing the risk of flare-ups.

Choice C reason: Montelukast is not used for acute asthma attacks due to its slow onset (hours). It is a maintenance therapy, not a rescue medication like albuterol, which provides rapid bronchodilation. Patients should carry beta-agonists, not montelukast, for acute symptom relief.

Choice D reason: Montelukast is an oral tablet, not an inhaled medication, so inhalation technique is irrelevant. Its action involves systemic leukotriene receptor blockade, reducing airway inflammation. Proper administration requires consistent daily dosing, not device-specific techniques, making this instruction incorrect for montelukast.

A. Metronidazole B. Vancomycin C. Tobramycin D. Ciprofloxacin

Correct Answer is B

Explanation

Choice A reason: Metronidazole is effective against anaerobic bacteria and protozoa, not gram-positive organisms like MRSA. It targets microbial DNA but lacks activity against Staphylococcus aureus, making it inappropriate for treating MRSA infections, which require antibiotics with specific gram-positive coverage.

Choice B reason: Vancomycin is a first-line treatment for MRSA infections. It inhibits cell wall synthesis by binding to peptidoglycan precursors, effective against gram-positive bacteria like MRSA. Its efficacy in multidrug-resistant infections makes it the preferred choice for serious infections like pressure ulcers in hospitalized patients.

Choice C reason: Tobramycin, an aminoglycoside, targets gram-negative bacteria and is not effective against MRSA, a gram-positive organism. Its spectrum includes Pseudomonas but not resistant Staphylococcus, making it unsuitable for treating MRSA pressure ulcers, which require vancomycin or similar agents.

Choice D reason: Ciprofloxacin, a fluoroquinolone, has some activity against gram-positive bacteria but is not a first-line choice for MRSA due to variable resistance. Vancomycin is more reliable for multidrug-resistant Staphylococcus aureus, especially in serious infections like pressure ulcers, making this an incorrect choice.

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The nurse is educating a client about an inhaled corticosteroid. What statement will the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The prescriber has changed the patient’s medication regimen to include the leukotriene receptor antagonist (LTRA) montelukast to treat asthma. The nurse will emphasize which point about this medication?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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